Evaluation of a Direct Oral Penicillin Challenge in a Rural Community

Inclusion Criteria: * Individuals in the Muskoka region, residing in the catchment area of Muskoka Algonquin Healthcare (Huntsville and South Muskoka site) who meet the following criteria are eligible for the study. Inclusion Criteria: * Greater than 18 years of age * In stable health * Penicillin allergy that is either self-reported, reported by their primary care provider or previously documented in their electronic medical record * Successfully screened to ensure they are low-risk for a penicillin allergy and have a PEN-FAST score of \<3 Screening Criteria: * Did not react to penicillin in the past 10 years * Was never hospitalized with a penicillin reaction * Have no evidence of a Severe Cutaneous Adverse Reaction (SCAR) * Have no evidence of a Drug-Related Eosinophilia and Systemic Symptoms (DRESS) * Have no history of Asthma * Cannot recall the nature of the penicillin reaction * Have a history of isolated non-allergic symptoms (eg. GI upset only) * Only have a family history of penicillin reaction * If suffer from pruritus (severe itching), with or without maculopapular rash after taking Amoxicillin * Have no history of IgE mediated hypersensitivity reaction or angioedema Exclusion Criteria: * Pregnancy * Active asthma or any other illness that will increase the participants' risk * Do not meet the low-risk screening criteria * Individuals who report an immune-mediated reaction to cephalosporins * Currently taking Beta Blockers, ACE inhibitors, antihistamines or…